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Fetal Heart Tracing

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161. Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report

-BasedClinicalPracticeGuidelines(9thEdition). TheoverallqualityoftheevidencewasassessedusingtheGRADE(GradingofRecommendations, Assessment, Development, and Evaluation) approach. Graded recommendations and ungraded consensus-basedstatementsweredrafted,votedon,andreviseduntilconsensuswasreached. RESULTS: ForpatientswithAFwithoutvalvularheartdisease,includingthosewithparoxysmal AF, who are at low risk of stroke (eg, CHA 2 DS 2 -VASc [congestive heart failure, hypertension, age$ 75 (doubled), diabetes, stroke (doubled)-vascular (...) Thromboembolic Events in Atrial Fibrillation; ATRIA = Anticoagulation and Risk Factors in Atrial Fibrillation; AVERROES = Apixaban Versus Acetylsalicylic Acid (ASA) to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment; BRIDGE = Bridging Anticoagulation in Patients who Require Tem- porary Interruption of Warfarin Therapy for an Elective Invasive Procedure or Surgery; CAA = cerebral amyloid angiopathy; CHA 2 DS 2 -VASc = congestive heart failure

2018 American College of Chest Physicians

162. Dinutuximab beta Apeiron - neuroblastoma

processing ECG Electrocardiogram ECHO Echocardiogram EEG Electroencephalogram EFS event-free survival ELISA Enzyme-linked immunosorbent assay EM(E)A European Medicines Agency EOT End of treatment EPC End of Production Cells Assessment Report - Dinutuximab beta Apeiron EMA/263814/2017 Page 5/129 ESI-TOF-MS Electrospray ionisation time-of-flight mass spectrometry FAS Full analysis set FCS Fetal calf serum Fc?R FC gamma receptor FDA Food and Drug Administration G0 Glycan without core fucose and no galactose (...) 150 kDa corresponding to the expected size of an intact IgG1, but smaller faint bands were also visible at about 100 kDa, 70kDa and 26kDa on the gels. The identity of these bands has been clarified as product-related variants of ch14.18/CHO, with only traces of HCP. Bands at 50kDa appear to contain heavy chain and two light chains, with the band at 25 kDa appearing to be mainly free light chain with low levels of HCP. Since these are all at levels well below the main band (by densitometry

2017 European Medicines Agency - EPARs

163. Improving the health of the public by 2040

of substantially, continually and sustainably improving health and health equity by identifying research needs and coordinating research activities. (Details of the proposed Coordinating Body can be found on page 58.) Recommendation 2 We recommend that key public and charitable research funders (such as Research Councils, the National Institute for Health Research and its devolved equivalents, the British Heart Foundation, Cancer Research UK and Wellcome) continue to work with relevant stakeholders (...) public and charitable research funders (such as Research Councils, the National Institute for Health Research and its devolved equivalents, the British Heart Foundation, Cancer Research UK and Wellcome) support research into: 1. Strengthening and developing methods of engagement between researchers and the public. 2. Strengthening and developing methods of communicating health messages that are appropriate to the values, culture and norms of different sectors of society. In both cases, particular

2017 Academy of Medical Sciences

164. CRACKCast E171 – Pediatric Cardiac Disorders

of Cardiac Disorders in Infants and Children) See Box 170.3 (Key Elements to Elicit in the History of a Child with a Known Cardiac Disorder) Let’s start this sauna-sweat-shop episode with a little anatomy review: Trace the path of the RBC during foetal circulation, and describe the changes that occur following delivery. Oxygen flow: mom’s lungs/body/placenta → umbilical vein → ductus venosus → fetal heart (through IVC) → right atrium → shunted to the left atrium by the patent foramen ovale → left (...) CRACKCast E171 – Pediatric Cardiac Disorders CRACKCast E171 - Pediatric Cardiac Disorders - CanadiEM CRACKCast E171 – Pediatric Cardiac Disorders In by Chris Lipp April 23, 2018 This episode of CRACKCast covers Rosen’s Chapter 171, Pediatric Cardiac Disorders. This chapter covers specific diseases of the pediatric heart and blood vessels, including congenital heart disease, Kawasaki Disease, murmurs, Acute Rheumatic Fever, and dysrhythmias. Shownotes – KEY CONCEPTS The possibility

2018 CandiEM

165. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio

)/factitious disorder by proxy (FDP) Hereditary fructose intolerance Child neglect or abuse Urea cycle defects Self-induced vomiting Amino and organic acidemias Cyclic vomiting syndrome Fatty acid oxidation disorders Rumination syndrome Metabolic acidosis Congenital adrenal hyperplasia/adrenal crisis Toxic Renal Lead poisoning Obstructive uropathy Other toxins Renal insuf?ciency Cardiac Heart failure Vascular ring Autonomic dysfunction ESPGHAN ¼ European Society for Pediatric Gastroenterology, Hepatology (...) indications for the performance of pH-MII in the evaluation of GERD. 1. Differentiate patients with NERD, hypersensitive esopha- gus and functional heartburn in patients with normal endoscopy. The recently published Rome IV criteria for esophageal disorders included new classi?cations for adults with typical GERD symptoms including chest pain and heart burn. In patients with persistent typical symptoms despite acid suppression, pH-MII can clarify the diagnosis of NERD (pathologic re?ux regardless

2018 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

166. WHO recommendations: intrapartum care for a positive childbirth experience

for assessment of fetal well-being in healthy pregnant women undergoing spontaneous labour. Not recommended Intermittent fetal heart rate auscultation during labour 18. Intermittent auscultation of the fetal heart rate with either a Doppler ultrasound device or Pinard fetal stethoscope is recommended for healthy pregnant women in labour. Recommended Epidural analgesia for pain relief 19. Epidural analgesia is recommended for healthy pregnant women requesting pain relief during labour, depending on a woman’s (...) ), a cosponsored programme executed by the WHO. The views of the funding bodies have not influenced the content of this guideline. Editing: Green Ink, United Kingdom.vii ACRONYMS AND ABBREVIATIONS Acronyms and abbreviations ABO adverse birth outcome aOR adjusted odds ratio CERQual Confidence in the Evidence from Reviews of Qualitative research CI confidence interval cRCT cluster randomized controlled trial CTG cardiotocography DOI declaration of interest EB evidence base EtD evidence-to-decision FHR fetal

2018 World Health Organisation Guidelines

167. The use of viscoelastic haemostatic assays in the management of major bleeding

using clinical measures (e.g. rising heart rate, falling blood pressure) but these measures can be insensitive, particularly in younger patients in whom blood loss can be masked and haemodynamic stability preserved or in elderly patients on cardiovascular modulating medication. Detection and correction of coagulopathy is therefore an important aspect of management of severe haemorrhage. The British Society for Haematology (BSH) guidelines (Hunt et al , ) recommend the use of serial standard (...) representation is made. A typical trace for TEG and ROTEM is shown in Fig and a Sonoclot trace is illustrated in Fig . Although TEG and ROTEM traces look identical, the parameters are not directly interchangeable and should not be regarded as equivalent (Coakley et al , ; Venema et al , ; Hagemo et al , ; Rizoli et al , ). Figure 1 Principles of Thromboelastography, Thromboelastometry and Sonoclot. Whole blood is placed in to the cup for each device. Activators are added as required and, as the test

2018 British Committee for Standards in Haematology

168. Heart (Full text)

of the right atrium is an oval-shaped depression known as the , which is a remnant of an opening in the fetal heart known as the . Most of the internal surface of the right atrium is smooth, the depression of the fossa ovalis is medial, and the anterior surface has prominent ridges of , which are also present in the . The right atrium is connected to the right ventricle by the . The walls of the right ventricle are lined with , ridges of cardiac muscle covered by endocardium. In addition to these muscular (...) heart. Further development will include the septa and valves formation and remodelling of the heart chambers. By the end of the fifth week the septa are complete and the heart valves are completed by the ninth week. Before the fifth week, there is an opening in the fetal heart known as the . The foramen ovale allowed blood in the fetal heart to pass directly from the right atrium to the left atrium, allowing some blood to bypass the lungs. Within seconds after birth, a flap of tissue known

2012 Wikipedia

169. Preterm labour and birth

blood cell count and measurement of fetal heart rate using cardiotocography) to diagnose intrauterine infection in women with P-PROM. 1.5.2 Do not use any one of the following in isolation to confirm or exclude intrauterine infection in women with P-PROM: a single test of C-reactive protein white blood cell count measurement of fetal heart rate using cardiotocography. 1.5.3 If the results of the clinical assessment or any of the tests are not consistent with each other, continue to observe the woman (...) reducing the dose of magnesium sulfate. 1.11 Fetal monitoring Monitoring options: cardiotocogr Monitoring options: cardiotocograph aphy and intermittent auscultation y and intermittent auscultation 1.11.1 Discuss with women in suspected, diagnosed or established preterm labour (and their family members or carers as appropriate): the purpose of fetal monitoring and what it involves the clinical decisions it informs at different gestational ages if appropriate, the option not to monitor the fetal heart

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

170. HTA of smoking cessation interventions

. Smoking during pregnancy is harmful. It is associated with an increased risk of congenital anomalies, preterm birth, intrauterine fetal growth restriction, placental abruption, stillbirth, sudden infant death syndrome, respiratory infection, adverse cognitive and behavioural outcomes in infancy, and the development of chronic disease in adulthood. Evidence shows that smokers with mental health disorders smoke more heavily, are more nicotine dependent, and have smoked for longer than smokers who do (...) with nicotine replacement therapy (NRT) are mild and temporary in nature. Commonly reported side effects include mild skin sensitivity (patch), hiccoughs and gastrointestinal disturbance (gum), local irritation of mouth, nose and throat (inhaler, spray and sublingual tablets). Chest pain and heart palpitations are the only potentially clinically significant serious adverse events to emerge from clinical trials. NRT does not appear to be associated with an increase in serious cardiovascular adverse events

2017 Health Information and Quality Authority

171. Hepatitis C in pregnancy: screening, treatment, and management (Full text)

compared with no internal monitoring. In contrast, a retrospective study with 724 women found no association. 60 One of these studies alsofoundthatepisiotomywassigni?cantlyassociatedwith an increased risk of vertical transmission. 59 Based on the availableevidence,werecommendthatobstetriccareproviders avoid internal fetal monitoring, prolonged rupture of membranes, andepisiotomyinmanaginglaborinHCV-positivewomen(GRADE 1B), unless it is unavoidable in the course of management (ie, when unable to trace (...) the fetal heart rate with Doppler and the alternative is proceeding with cesarean delivery). We also recommend that obstetric care providers avoid early amniotomy and episiotomy in managing labor in HCV-positive women. Expectant management of ruptured membranes should be avoided at term and patients with rupturedmembranesattermshouldbeactivelymanagedin labor.Thereareinadequatedataregardingtheperinatalrisk of hepatitis C transmission with expectant management in the setting of prolonged preterm rupture

2017 Society for Maternal-Fetal Medicine

172. Management of bleeding in the late preterm period (Full text)

abruption is defined as placental separation, either partial or complete, prior to delivery. Classically, women with placental abruption present with abdominal pain and bleeding, and approximately 60% will also have a nonreassuring fetal heart rate tracing. x 32 Hurd, W.W., Miodovnik, M., Hertzberg, V., and Lavin, J.P. Selective management of abruptio placentae: A prospective study. Obstet Gynecol . 1983 ; 61 : 467–473 | | | Numerous risk factors for placental abruption have been described (...) : 911–915 | | | | | If the diagnosis is unclear, bleeding is minimal, and the maternal and fetal status remain stable, delivery may be delayed with close surveillance and ongoing fetal testing. However, as with other women presenting with active hemorrhage from any etiology in the late preterm period, delivery is indicated in the setting of abruption with significant vaginal bleeding, abnormal laboratory results including acute anemia or coagulopathy, abnormality of the fetal heart tracing

2017 Society for Maternal-Fetal Medicine

173. First Trimester Vaginal Bleeding

heart rate by 8 weeks at US. Radiology. 2005;236(2):643-646. 25. Bromley B, Harlow BL, Laboda LA, Benacerraf BR. Small sac size in the first trimester: a predictor of poor fetal outcome. Radiology. 1991;178(2):375-377. ACR Appropriateness Criteria ® 9 First Trimester Vaginal Bleeding 26. Horrow MM. Enlarged amniotic cavity: a new sonographic sign of early embryonic death. AJR Am J Roentgenol. 1992;158(2):359-362. 27. McKenna KM, Feldstein VA, Goldstein RB, Filly RA. The empty amnion: a sign of early (...) pregnancy. In this setting, echoes within the free fluid are often due to blood. Trace anechoic free fluid in the pelvis is generally normal. The presence of more than a normal small amount of free fluid or echoes within the fluid, even without identification of an extraovarian mass, is concerning for an ectopic pregnancy [42-44]. However, this finding is not specific and can also occur for other reasons, such as rupture of a hemorrhagic ovarian cyst with an early, nonvisualized IUP. A minority

2017 American College of Radiology

175. Intrapartum care for healthy women and babies

, she will need to be transferred to obstetric-led care. [2017] [2017] 1.4.9 Offer continuous cardiotocography if any of the risk factors listed in recommendation 1.4.3 are identified on initial assessment, and explain to the woman why this is being offered. (See also section 1.10 on fetal monitoring.) [2017] [2017] 1.4.10 Offer cardiotocography if intermittent auscultation indicates possible fetal heart rate abnormalities, and explain to the woman why this is being offered. If the trace is normal (...) tr ansferred (% of total transferred from each ansferred from each setting) setting) F From home rom home (n=3,529) (n=3,529) F From a freestanding rom a freestanding midwifery unit (n=2,457) midwifery unit (n=2,457) F From an alongside rom an alongside midwifery unit midwifery unit (n=4,401) (n=4,401) Delay during first or second stage of labour 1,144 (32.4%) 912 (37.1%) 1,548 (35.2%) Abnormal fetal heart rate 246 (7.0%) 259 (10.5%) 477 (10.8%) Request for regional analgesia 180 (5.1%) 163 (6.6

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

176. Standards for obstetrical ultrasound assessments

and facilities and expertise exist to perform this assessment, the ultrasound components should include: 1? Breathing movements 2? Movements 3? Tone 4? Amniotic Fluid Volume 5? Reactive Fetal Heart Rate ? ? Manning FA? Dynamic ultrasound-based fetal assessment: the fetal biophysical profile score? Clin Obstet Gynecol. 1995;38(1):26–44. ESTIMATED FETAL WEIGHT (EFW) Although the determination of Estimated Fetal Weight (EFW) is not considered to be a minimum assessment requirement for an OB ultrasound (...) / absence of yolk sac or embryo ? ? Fetal number: ? ? if multiple – chorionicity and amnionicity ? ? Location of gestational sac ? ? Cardiac activity: ? ? Presence / absence ? ? Fetal Heart Rate (FHR) ? ? Crown rump length (CRL) ? ? Maternal pelvic anatomy (adnexa, ovaries, cervix) ? ? Head circumference (HC) ? ? Biparietal diameter (BPD) ? ? Choroid plexus filled ventricles ? ? Stomach ? ? Symmetrical lung fields ? ? Presence of 4 limbs, each with 3 segments ? ? Abdominal wall cord insertion ? ? NT

2016 CPG Infobase

177. Prediction of neonatal acidemia by computer analysis of fetal heart rate and ST event signals. (PubMed)

Prediction of neonatal acidemia by computer analysis of fetal heart rate and ST event signals. The objective of the study was to evaluate the accuracy of computer analysis of fetal heart rate (FHR) and ST event signals in prediction of neonatal acidemia.One hundred forty-eight FHR tracings were evaluated to identify red alerts provided by the system, based on automated analysis of FHR and ST event signals, and compared with the occurrence of umbilical artery acidemia (pH < or =7.05

2009 American Journal of Obstetrics and Gynecology

178. Computerized analysis of normal fetal heart rate pattern throughout gestation. (Full text)

Computerized analysis of normal fetal heart rate pattern throughout gestation. To analyze the evolution of computerized cardiotocography (cCTG) parameters throughout gestation in a large archive of traces from healthy fetuses.This was a cross-sectional study of the first cCTG record from 4412 singleton fetuses with good pregnancy outcome. Normal ranges of cCTG parameters for 25 to 42 weeks were derived from analysis of only one cCTG record per fetus, and the relationship between the parameters (...) and gestational age was investigated.Fetal heart rate (FHR) accelerations, short- and long-term variation overall, duration of episodes of high and low variation and variation in high episodes increased with advancing gestation. In contrast, maternal perception of fetal movements, basal FHR, variation in low episodes and the time until criteria for normality were met decreased with advancing gestation. Gestational age-related changes in FHR variation were less evident at the lowest percentiles. Episodes

2009 Ultrasound in Obstetrics and Gynecology

179. National minimum retesting intervals in pathology: A final report detailing consensus recommendations for minimum retesting intervals for use in pathology

Formulary BSPGHAN British Society of Paediatric Gastroenterology, Hepatology and Nutrition BSH British Society for Haematology C3 Complement component C3 C4 Complement component C4 CA12.5 Carbohydrate antigen 12.5 CA15.3 Carbohydrate 15.3 CA 19.9 Carbohydrate antigen 19.9 CDC Center for Disease Control CCP Cyclic citrullinated peptide antibody CEA Carcinoembryonic antigen CFT Complement fixation test CG Clinical Guideline CHF Congestive heart failure CKD Chronic kidney disease CKS Clinical Knowledge (...) Implementation Network GGT Gamma-glutamyltransferase GPC Gastric parietal cell antibody Hb Haemoglobin HBV Hepatitis B virus HCV Hepatitis C virus CEff 161215 8 V7 Final HIV Human immunodeficiency virus HSV Herpes simplex virus HVS High vaginal swab Ig Immunoglobulin IGF-1 Insulin-like Growth Factor 1 IHD Ischaemic heart disease INR International normalised ratio ITT Immune tolerance therapy ITU Intensive treatment unit IUCD Intrauterine contraceptive device IV Intravenous IVF In vitro fertilisation LCMS

2016 Royal College of Pathologists

180. Ixazomib (Ninlaro) - multiple myeloma

on a 28-day cycle (the multiple is significantly greater when accounting for human plasma protein binding). A telemetry in vivo study was performed in beagle dogs to evaluate the effects of ixazomib on the CVS. ECG, nervous system, and respiratory evaluations were also conducted as part of GLP-compliant repeated-dose toxicology studies in rats and dogs. No treatment-related effects on blood pressure, heart rate, or ECG parameters (including PR interval, QRS duration, QT interval, and corrected QT (...) . In blood, the highest concentration of drug-derived radioactivity was 0.439 µg equiv/g, observed at 0.5 hours post-dose; in plasma, the highest concentration of total drug-derived radioactivity was 0.250 µg equiv/g, also observed at 0.5 hours. The tissues with the lowest relative concentrations (= 0.03 µg equiv/g) at tmax were the brain, spinal cord, testis, bone, and eye lens. For most tissues, elimination was nearly complete by 672 hours post-dose, with trace amounts of radioactivity still observed

2016 European Medicines Agency - EPARs

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